DISCOVERY
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BETTER, MORE COST-EFFECTIVE WAYS TO HELP PATIENTS
Health-care costs are a concern for everyone and are at the heart of a national debate about health insurance. Working with partners including Tallahassee Memorial HealthCare( TMH), the FSU College of Communication and Information and the University of Florida, the College of Medicine is studying effective ways to reduce health-care costs while maintaining and improving outcomes. One such project is underway at the Transition Center, opened in 2011 to provide follow-up care for patients discharged from TMH who are at risk for readmission. Known as a“ demonstration project,” the research involves studying the effectiveness of telehealth interventions for several patient groups at risk for hospital readmission, which is expensive and sometimes avoidable. The search involves four telehealth strategies for care provided to various Transition Center patients:
· Post-discharge phone calls for congestive heartfailure patients. The calls address a number of issues that often lead to hospital readmission, including: uncertainty about the discharge instructions; incorrect use of prescribed medications; and problems with scheduling and / or attending post-discharge care appointments.
· Nursing home consultations that address problems arising from the common lack of full-time medical directors or nursing staff with expertise in geriatrics. Without such expertise, problematic changes in patient vital signs can be missed, leading to a default response of sending patients to the emergency room. Using Bluetooth technology, Transition Center clinicians monitor nursing-home patient vital signs daily and call when an intervention is needed, which might include bringing those patients back to the center for a follow-up.
· Remote monitoring of high-risk patients. Again, using Bluetooth technology, Transition Center clinicians monitor weight and blood pressure signs to allow a timely response if problematic changes occur.
· Post-surgical monitoring for hip and knee replacement patients. TMH and Tallahassee Orthopedic Clinic provide telemedicine follow-up consultations and assessments.
Early analyses of some of the behavioral health interventions reveal a pattern of reduced health-care costs. A sample of 143 patients over a one-year period following at least one office visit to the Transition Center showed a 65-percent reduction in number of days spent at the hospital. Projected over an entire year, the decrease among a relatively small cross-section of Transition Center patients translates to nearly a $ 1 million reduction in health-care costs.“ These are important demonstration projects to show how we do things that actually change health outcomes,” said Senior Associate Dean Jeffrey Joyce.“ Some funds from our clinical translational science award with the University of Florida help to pay for a database analyst embedded at the Transition Center.“ By doing that, we’ re able to analyze already existing data to show there are better outcomes associated with a particular type of care. This is the type of work that can demonstrate the value of an intervention that could be used to help numerous patients elsewhere while also potentially lowering costs.”